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scientific medicine, they will regard gathering such data as one of their professional responsibilities. Our judgment that many persons who are suicidal have a future of value has a sound empirical basis. It is indeed no more difficult to determine what a person’s present ideal desire is in these cases than it is to determine whether or not such a person has a future of value. This is because someone’s present ideal desire is nothing more than the desire of a rational and fully informed individual in that individual’s situation, and a rational, fully informed desire about one’s own future is based on the judgment that a rational and prudent individual would make about the value of her future. ( Tricky issues arise in contexts in which duties to others are involved, of course.) Therefore, Hans will have an ideal desire to live just in case a rationally, fully informed individual in Hans’s situation will judge that his future life has positive value as compared with death. A rationally, fully informed individual in Hans’s situation will judge that Hans’s life has positive value as compared with death just in case Hans has a future of value. Boonin’s claim that the present ideal desire view and the future of value view will pick out (with one rare exception) the same range of (postnatal) cases is quite true. It is true because the present ideal desire view, when explicated in an obvious way, is parasitic upon the future of value view! The present ideal desire view turns out to be concerned, in the final analysis, neither with one’s desires, as contrasted with one’s future welfare, nor with one’s present as compared to one’s future. Thus, although Boonin’s claim that the future of value view fails the salience test is incorrect, his claim that the present ideal desire view is salient is correct. It is salient because it is the future of value account stated in the language of desires.

Boonin’s Counterexample Argument

Boonin believes that there is a counterexample to the future of value view that is not a counterexample to the present ideal desire view. He asks us to imagine a case of a person whose future will contain many of the sorts of experiences other humans take to be valuable, but, because of an irreversible chemical imbalance in her brain, does not now and never will value any of those experiences. Boonin claims that the future of value theory implies that it would not be wrong to kill this person. He is correct. Boonin claims that the present ideal desire view entails that this person ‘has the same right to life as you and I’. Is this true?

The ideal desire view asks us to imagine what a fully informed rational person would presently desire in this chemical imbalance case. So let us imagine that we ourselves are in this chemical imbalance situation, but that there is a drug that can relieve us of the imbalance only temporarily, only briefly, and only once so that we can survey our future rationally and with full information. It is hard to imagine why such a person would have the present desire to live after the drug was no longer effective. Boonin’s analysis of this alleged counterexample is incorrect.

Boonin’s argument fails in another respect. Suppose his analysis were correct and our chemically imbalanced individual did have the ideal desire to live. Why should this show that the future of value theory is false? Because, says Boonin, ‘virtually every critic of abortion will agree that [this individual] has a right to life’ (Boonin 2003: 77). Boonin’s criterion of truth is not correct. If it were, then we would have a (too easy) proof for the existence of God! We may conclude that none of Boonin’s arguments for the superiority of the ideal desire account over the future of value account of the wrongness of killing is successful.

Why Boonin’s Account Is Arbitrary

Boonin’s ideal desire account of the wrongness of killing suffers from another problem. At least two versions of an ideal desire account are possible. On Boonin’s version, having an ideal desire at a time requires having some actual desire at that time. An ideal desire is an actual desire that is corrected, when necessary, to account for imperfect information and imperfect rationality. Because no preconscious foetus has an actual desire, no preconscious foetus has an ideal desire to live, and because no preconscious foetus has an ideal desire to live, no preconscious foetus has the right to life. However, the Boonin version of the ideal desire account could be altered so that the actual desire requirement is dropped. Then foetuses could have ideal desires also. So just as Hans, were he fully rational and fully informed, would have the desire to continue to exist, a preconscious foetus, were she rational and fully informed, would have (because she, like Hans, has a future of value) the desire to continue to exist. Why prefer Boonin’s version of the ideal desire account to the ‘Marquis version’ of the ideal desire account? The characterization of the second version is apt because, of course, such a version of the ideal desire account is just the future of value account in ideal desire clothing.

Boonin emphasizes that his preferred account is the Boonin, not the Marquis, version. That is no argument. Boonin notes the differences between the Boonin and the Marquis versions of the ideal desire account (Boonin 2003: 80 – 3). That is no argument either. Perhaps Boonin regards the following as an argument: ‘There is no desire that a rock would have under more ideal circumstances, for example, because a rock does not have any desires to begin with. But it follows from this that a particular ideal desire can meaningfully be attributed only to someone who has at least some other actual desires’ (Boonin 2003: 80). If this is a claim about Boonin’s version of the ideal desire theory, this is true, but does not establish the superiority of Boonin’s version. One would not attribute even ideal desires to rocks because there is no present or future stage of the rock that it would later value or disvalue. Foetuses are quite different. Hypothetical desires can be attributed as easily to foetuses as to Hans. There are reasonably clear criteria for the attribution in both cases. Accordingly, even if Boonin had shown that an ideal desire account of

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the wrongness of killing were superior to the future of value account, he still would not have established that his ideal desire account of the wrongness of killing should be accepted. Hence, he would not have adequately defended abortion choice.

We may safely conclude that, although Boonin’s ideal desire version of Tooley’s desire account of the wrongness of killing is not vulnerable to counterexamples, Boonin fails to show that his theory is better than the future of value theory. Indeed, if we eliminate an arbitrary feature of Boonin’s theory, Boonin could not have shown that the ideal desire theory is preferable to the future of value theory. With this elimination, the ideal desire theory is the same as the future of value theory.

SUMMARY AND CONCLUSION

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A brief survey of the analysis of this chapter will be useful. Think of individuals whom we all agree it is presumptively seriously wrong to kill. If pressed, we might say that it is wrong to kill them because they are human beings or because they are persons. Each reason has different implications for the ethics of abortion. There are difficulties, as we have seen, with each reason. A number of philosophers have attempted to resolve the abortion controversy by finding reasons for the wrongness of killing embedded in broader, and clearly relevant, moral considerations. There are at least three such accounts. The desire account is based on the moral truth that, in general, impeding the self-regarding desires of others is wrong. The future of value account is based on the moral truth that, in general, inflicting harm on others is wrong when we would regard it as wrong to inflict a harm of that sort on us. The moral agency account is based on the moral truth that, in general, failing to respect the will of rational moral agents is wrong. The purpose of this chapter was to appraise these three accounts, all of which are intended to support particular views of the ethics of abortion.

The future of value account seems to deal adequately with cases in which there is a consensus that killing is wrong and also with cases in which few object to ending intentionally a life. It supports the view that abortion is immoral. Is there an account that is at least as plausible that underwrites abortion choice? According to the desire account, because foetuses do not desire to live, they lack the right to life. The desire argument strategy fails because many adults who do not desire to live plainly do have the right to life. David Boonin has attempted to plug the holes in this Tooleyan actual desire account by proposing to replace it with an ideal desire account. However, Boonin’s strategy faces, as we have seen, many difficulties. In general, our duty not to interfere with the desires of others is a duty not to impede their actual desires, not their ideal desires when those ideal desires are different. Furthermore, the ideal desire view, in order to deal adequately with consensus cases, turns out to be parasitic on the future of value view. In addition, Boonin preserves

abortion choice only by adopting an ad hoc restriction to avoid attributing ideal desires to foetuses.

Mary Anne Warren’s (1997) defense of abortion choice shares a difficulty with the actual desire account: Her Agent’s Rights principle, although it clearly embodies a generally acknowledged principle of respect, fails to account for the wrongness of killing many individuals whom we all believe it is wrong to kill. Warren attempts to deal with this gap by adding a Human Rights principle to her account. Because her Human Rights principle does not fit easily into a general theory of wrong action her defense of this principle is inadequate. It seems more like an ad hoc attempt to deal with the problems with her view. Worse, without utterly arbitrary restrictions to the Human Rights principle, the principle supports the claim that abortion is immoral.

Interestingly, Warren’s and Boonin’s views are similar. Neither a ‘bare bones’ desire view nor a respect for moral agency view account for the wrongness of killing all those who clearly have the right to life. Hence, strategies must be found for expanding both views. Unless arbitrary restrictions are placed on both expansions, both views will support the view that abortion is immoral. Hence, both Warren and Boonin, in the final analysis, must restrict their accounts in arbitrary ways.

The analysis of this chapter supports the conclusion that, of the alternatives considered in this chapter, the future of value view is superior and abortion is immoral. There are, of course, other alternatives to, and objections to, the future of value view that have not been discussed in this chapter. Furthermore, the important view that, even if foetuses have the right to life, women do not have the obligation to provide them with uterine life support also has not been considered.

REFERENCES

BOONIN, D. (2003), A Defense of Abortion (Cambridge: Cambridge University Press). MCMAHAN, J. (2002), The Ethics of Killing: Problems at the Margins of Life (New York:

Oxford University Press).

MARQUIS, D. (1989), ‘Why Abortion Is Immoral’, Journal of Philosophy, 89: 183 – 202. PURDY, L., and TOOLEY, M. (1974), ‘Is Abortion Murder?’, in R. Perkins (ed.), Abortion: Pro

and Con (Cambridge, Mass.: Schenkman).

STONE, J. (1987), ‘Why Potentiality Matters’, Canadian Journal of Philosophy, 17: 815 – 30. TOOLEY, M. (1972), ‘Abortion and Infanticide’, Philosophy and Public Affairs, 2: 37 – 65.

(1973), ‘A Defense of Abortion and Infanticide’, in J. Feinberg (ed.), The Problem of Abortion, 1st edn. (Belmont, Calif.: Wadsworth), 51 – 91.

(1983), Abortion and Infanticide (Oxford: Clarendon Press).

WARREN, M. A. (1979), ‘On the Moral and Legal Status of Abortion’, repr. in R. A. Wasserstrom (ed.), Today’s Moral Problems, 2nd edn. (New York: Macmillan), 35 – 51.

(1997), Moral Status: Obligations to Persons and Other Living Things (Oxford: Clarendon Press).

c h a p t e r 1 8

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M O R A L S TAT U S , M O R A L VA LU E , A N D

H U M A N E M B RYO S : I M P L I C AT I O N S F O R S T E M C E L L

R E S E A R C H

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B O N N I E S T E I N B O C K

INT RO DUC T I ON

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HUMAN embryonic stem cells (ES cells) are of scientific and medical interest because of their ability to develop into different tissue types and because of their ability to be propagated for many generations in laboratory culture. Grown in a laboratory,

The first version of this chapter was given at the 24th Annual Philosophy Conference on moral status, held at the University of Santa Clara in 2002. I owe thanks to its organizer, Larry Nelson, for inviting me to write on the topic, and to the participants for helpful and searching comments. Versions were also presented to the Philosophy Departments at Utah University, Syracuse University, and Carnegie Mellon, where the discussions were extremely helpful. Finally, I owe a large debt to Alex John London and David DeGrazia for very helpful comments on an earlier draft.

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they might one day be used in the treatment of degenerative diseases such as Parkinson’s and Alzheimer’s. They could provide bone cells for the treatment of osteoporosis, eye cells for macular degeneration, blood cells for cancer, insulinproducing cells for diabetes, heart muscle cells for heart disease, nerve cells for spinal cord injury. The potential for benefit to so many people is a strong argument for doing — and funding — embryonic stem cell (ESC) research. Yet ESC research is very controversial because the derivation of ES cells — at least at the present time — destroys the embryo. Thus, the morality of ESC research depends primarily on the morality of destroying human embryos, raising the question of the moral status of the human embryo.1

This chapter begins with an introduction to the biology behind ESC research. Next I present briefly four views of moral status, based on four different criteria: biological humanity, personhood, possession of interests, and having a future- like-ours (FLO). On two of these views (the person view and the interest view), embryos clearly lack moral status, but they most likely do not have moral status on the FLO account either. Only the biological humanity criterion combined with the view that life begins at conception results in the conclusion that very early extracorporeal embryos have full moral status, making ESC research that destroys embryos morally wrong. This explains why even some who are anti-abortion are not against ESC research: they do not view the very early, extracorporeal embryo as having the same moral status as the fetus. However, the morality of stem cell research is not completely determined by the question of moral status, for that issue, I argue, is not exhaustive of morality. Some entities, including human embryos, that do not have moral status nevertheless have moral value, and are entitled to respect. In the last section of the chapter, I give an account of what this respect requires and how it differs from Kantian respect. I conclude that the respect due to embryos is consistent with ESC research; that it is ethically acceptable to use either cloned embryos or spare IVF (in vitro fertilization) embryos; and that there are no ethical (as opposed to political) reasons that demand the development of alternative sources of human pluripotent stem cells.

EMBRYOS A N D ES CELLS

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In the normal course of events, an embryo is the product of fertilization, the union of male and female gametes.2 Once fertilization is completed, the resulting

1 Paul Lauritzen (2005) disagrees. He thinks that the real concern is not the status of the embryo but that stem cell therapies, including both adult and embryonic stem cells, may erode the notion of human nature by undermining the notion of a natural human lifespan, or by blurring species boundaries.s

2 Embryos can also be created without fertilization via cloning or parthenogenesis.

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While it took them 200 tries to derive just one cell line in 2004, they reported in 2005 that they were able consistently to derive a cell line in fewer than twenty tries. Unfortunately, it was later discovered that Dr Hwang had fabricated evidence for all of that research. This was a sharp set-back for therapeutic cloning, ‘forcing cloning researchers back to square one’ (Wade and Sang-Hun 2006: A12). At the time of this writing, no one has managed to clone a human embryo, although several laboratories are pursuing this goal. The advantage of cloned over fertilized embryos is that the derived stem cells will have the same genome as the donor. If it becomes possible to create tissue for replacement purposes, the fact that the tissue is genetically identical to the donor should, in theory, avoid problems of rejection.

A similar advantage might be obtained using parthenogenesis, a process by which an unfertilized egg is chemically stimulated to divide into what scientists call ‘parthenotes’ — embryo-like products from which stem cells may be extracted. Tissue from stem cells derived from parthenogenesis would be easier to match with patients and less likely to be rejected because the parthenote would contain the DNA of only one person. Moreover, because a parthenote is assumed to lack entirely the potential for development as a human being, it is therefore, arguably, not a true embryo. Its creation and destruction might, therefore, raise fewer ethical concerns than those raised by embryos.

Other Kinds of Stem Cells

Embryonic stem cells are not the only kind of stem cells. Another kind of stem cell is embryonic germ (EG) cells, which are isolated from the gonadal ridges of 5- to 9-week-old fetuses donated after induced abortions. Although there are fewer data from animal EG cell experiments than from ES cell experiments, it is assumed that EG cells have less plasticity, that is, less ability to become different kinds of cells than ES cells, because the EG cells are much further along in development (five to nine weeks as opposed to five to nine days).There are also adult stem (AS) cells, which have been found in many different kinds of tissue, including bone marrow and heart muscle, as well as umbilical cord blood and the placenta. Although the term ‘adult stem cells’ is widely used, it is slightly misleading, as AS cells are not found only in adults; they are found in children and even in fetuses. A more accurate, though less commonly used, term is ‘non-embryonic stem cell’. The primary function of AS cells is to maintain and repair the tissue or cells in which they are found. Research into AS cells does not raise any special ethical issues (beyond the usual ones involved in any research using human subjects) because AS cells can be collected without lasting harm to the donor. However, many scientists believe that AS cells have less clinical promise than ES cells precisely because they are more differentiated and therefore likely to give rise only to a limited number of

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tissues. For this reason, they are sometimes described as multipotent, rather than pluripotent (Chapman et al. 1999). However, other scientists argue that, unlike ES cells, AS cells have already proved successful in the treatment of disease, for example, in bone marrow transplants, which have been done for the past thirty years. In November 2004 two studies in the New England Journal of Medicine (Laughlin et al.; Rocha et al.) concluded that umbilical cord blood works nearly as well as bone marrow transplanted from unrelated donors for leukemia patients. Another potential substitute for ethically controversial ES cells is multipotent cells derived from post-birth human placentas. Such cells could be derived without killing embryos, and might prove to have greater potential than AS cells (Yen et al. 2005). However, it could be a decade before the required tests and clinical trials to determine the viability of placenta-derived multipotent cells (PDMCs) are completed.

Admittedly, no one can know at this point whether ES cells will live up to their therapeutic promise, or if they will prove more successful than AS cells or PDMCs in the treatment of disease (Schwartz 2006). AS cells might prove better for some diseases than ES cells, despite the greater plasticity of ES cells. At the same time, the fact that no therapies have yet been developed using ES cells is surely no reason not to engage in ESC research. From a scientific perspective, it makes sense to do research on all of these alternatives. The real objection to ESC research is moral, not scientific. It is based on the opposition to the destruction of human embryos in biomedical research. ‘At the heart of the debates over stem cells and cloning are questions that politicians cannot settle: When does human life begin, and what is the moral status of the human embryo?’ (Stolberg 2001). To decide how we should think about human embryos, we need an account of moral status.

THE BI O LO G I C A L HU M A N I T Y VIE W

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In the Western moral and legal tradition, it is often taken for granted that what gives someone (full) moral status and moral rights is biological humanity. All and only members of the species Homo sapiens have full moral status and moral rights. This view of moral status is derived from the Judeo-Christian tradition, which teaches, first, that human beings alone of creation are created in God’s image, which gives human beings a status far superior to the rest of creation, and second, that all human beings are created in God’s image, which makes us all God’s children. The Judeo-Christian approach is clearly a moral advance over earlier views that limited moral status to members of one’s own group or tribe. Theoretically (though often not in reality), it prohibited the enslaving or killing of other human beings simply because they were outsiders. On the traditional view of moral status, all human beings count, regardless of race, ethnicity, nationality, or gender.

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When Does Human Life Begin? The Conception View

The biological humanity view holds that it is human beings who have moral status. But what is a human being? ‘Human being’ cannot be defined as any entity with a human genetic code, because every cell in a human body has a human genetic code. The biological humanity criterion must be understood as according moral status to the human organism: an integrated whole with the capacity for self-directed development. Otherwise, there is no way to distinguish human cells, which are merely parts of a human organism, from the organism itself. The next question is ‘When is there a human organism?’ or ‘When does the human organism begin to exist?’ One answer is that a human organism comes into existence at conception or fertilization (let us call this the ‘conception view’). If we combine the biological humanity criterion of moral status with the conception view about when a human organism begins, we get the view that a fertilized human egg, or human zygote, is a human being with the same moral status as any other human being, such as you or I.

Proponents of the conception view usually hold it to be a matter of ‘plain biological fact’ that a human organism begins at conception. However, the biological facts are not so simple, owing to the complexities of conception. Contrary to much of the anti-abortion literature, there is no ‘moment of conception’. The uniting of sperm and egg — fertilization — is a process that occurs over many hours. Understanding the biology of conception presents complications to the simple picture of the uniting of sperm and egg as the beginning of human life.

During the first hours after penetration, the genetic material provided by the male and female remain segregated. The chromosomes of the egg and sperm remain in their own nuclear envelopes, known as pronuclei, because each contains only half the genetic material found in the normal nuclei of somatic cells. The chromosomes in the two pronuclei duplicate themselves separately, as they migrate toward each other. Once the single-cell zygote divides, the envelopes surrounding the two pronuclei dissolve, and the condensed chromosomes of both paternal and maternal origin align on a common spindle. This merging of chromosomes, known as syngamy, does not occur until the two-cell stage. Now each of the two nuclei of the two-cell embryo contains a complete set of forty-six chromosomes, and fertilization is complete (Silver 1998: 45). This occurs about thirty hours after initial contact of sperm and egg (Mauron 2004: 708). However, it is not clear that there is a uniquely individuated organism even at the two-cell stage, because of what is known as the twinning argument. The blastocyst contains inner mass cells (blastomeres), which are totipotent. Each is capable, if properly manipulated, of developing into a full human being (Green 2001: 48). Embryo splitting occurs naturally in the case of identical twins (or triplets or even quadruplets or quintuplets). Mary Warnock, Chair of the Warnock Committee in Great Britain, alluded to the possibility of twinning by saying, ‘Before fourteen days the embryo hasn’t